Progression pattern of neurological disability with respect to clinical attacks in anti-MOG antibody-associated...

Area of Science:

• Neuroimmunology
• Neurology
• Clinical Neuroscience

Background:

• Anti-myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are inflammatory demyelinating diseases.
• Understanding the long-term disability progression patterns in MOGAD is essential for effective patient management.

Purpose of the Study:

• To evaluate the pattern of neurological disability progression in patients with MOGAD.
• To determine the relationship between clinical attacks, relapses, and disability worsening in MOGAD.

Main Methods:

• Longitudinal evaluation of neurological disability over 408 person-years in 50 MOGAD patients.
• Annual assessment of disability and detailed recording of clinical attacks and relapses.

Main Results:

• Over 30% of patients experienced clinical relapses within the first 5 years.
• Disability progression independent of relapse activity (PIRA) was not observed.
• Stepwise disability progression occurred following clinical attacks in some patients, with worsening more frequent after relapses than the initial episode (p < 0.01).

Conclusions:

• Neurological disability progression in MOGAD is primarily attack-related and stepwise, not PIRA.
• The findings highlight the critical importance of relapse prevention strategies in managing MOGAD.
• MOGAD disability progression patterns resemble those seen in anti-aquaporin-4 antibody disorders, emphasizing shared management principles.